title: Effect of laser fragmentation of cholesterol and mixed gallstones on in vitro dissolution in methyl tert-butyl ether.
abstract: This study examined cholesterol and mixed gallstone dissolution in vitro by methyl-tert-butyl ether (MTBE) after gallstone fragmentation. Three morphologically identical gallstones were obtained from 42 patients. One stone from each patient was fragmented with laser energy at a wavelength of 504 nm delivered to the stone surface with a 320-microns quartz fiber. Intact and fragmented stones from the same patient were incubated without stirring in MTBE and dissolution was expressed as the percent of initial stone weight remaining after 2 hr. Stone composition did not correlate with the amount of laser energy required for stone fragmentation. Fragmented stones dissolved faster than intact stones in MTBE with 13.97% +/- 0.37% vs 31.0% +/- 0.51% respectively (mean +/- SEM) of initial stone weight remaining at 2 hr (P less than 0.0001). Initial stone weight and stone matrix content significantly predicted dissolution of intact (P = 0.0033 and P = 0.0483, respectively) and fragmented stones (P = 0.003 and P = 0.0001, respectively) in MTBE. These data suggest that the gallstone matrix may inhibit stone dissolution even after stone fragmentation.
authors.affiliation: Section of the Gastroenterology and Hepatology, Boston City Hospital, Boston University School of Medicine, Massachusetts 02118.
authors.forename: B F
authors.initials: BF
authors.lastname: Smith
mesh_terms: D002769:Cholelithiasis / Q000378:metabolism / Q000473:pathology*; D002784:Cholesterol / Q000378:metabolism*; D004987:Ethers / Q000494:pharmacology*; D006801:Humans; D007834:Lasers; D008738:Methyl Ethers; D012995:Solubility; D012997:Solvents
chemical_list: D004987:Ethers; D008738:Methyl Ethers; D012997:Solvents; C043243:methyl tert-butyl ether; D002784:Cholesterol